Biomedical subjects
Siti Setiati
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Prevalence of hypertension without anti-hypertensive medications and its association with social demographic characteristics among 40 years and above adult population in Indonesia.
AIM: To find out the prevalence of hypertension without anti-hypertensive medication and its social demographic risk factors among adult population in Indonesia. METHODS: Random samples of 3080 subjects aged 40-94 years were obtained from various districts in every big island in Indonesia. Blood pressure measurements, as well as assessment on history of hypertension, use of anti-hypertensive medications, and social demographic characteristics were performed. Blood pressure measurements were obtained by trained doctors with the subjects in supine position. Stepwise multiple logistic regression was used to determine variables which were most associated with treatment without anti-hypertensive medication in hypertensive subjects. RESULTS: The prevalence of hypertension without anti-hypertensive medication among 40 years and above adult population in Indonesia was 37.32% (677 our of 1814 hypertensive subjects). From bivariate analysis, we found that male sex, older age, informal education and unemployment were associated with the use of anti-hypertensive medication. Multivariate analysis shows that male sex (OR=1.33), education level of elementary school (OR=1.50), and government employment (OR=1.24) are significantly as risk factors for not taking anti-hypertensive medication. Age more than 60 years old (OR=0.49) and unemployment (OR=0.70) are protective factors for not taking anti-hypertensive medication. CONCLUSION: The prevalence of hypertension without anti-hypertensive medication in this study is higher than the prevalence found in some other studies, and due to several social demographic risk factors, such as low level education, male sex, and being government employees. On the other hand, older people and those who have no formal occupation are protective factors.
Insulin resistance and metabolic syndrome in elderly women living in nursing homes.
AIM: To obtain a depiction of insulin resistance and to determine the correlation between age, body mass index, and insulin resistance, and the prevalence of metabolic syndrome in elderly women living in nursing homes. METHODS: Ninety two elderly females with an average age of 71.4 (SD 7.45) who did not suffer from chronic renal disease or chronic liver disease and were not taking corticosteroids, beta blockers, thiazides, or anti-dyslipidemic drugs, participated as research subjects. Investigated variables, comprising blood pressure, body mass index, waist circumference, laboratory measurements, lipid profile, fasting blood glucose level, and fasting insulin level, were used to determine insulin resistance according to HOMA-IR > 75 percentile. The NCEP ATP III criteria Asia Pacific modification was used to determine metabolic syndrome. RESULTS: There were twenty three subjects with insulin resistance (HOMA-IR > 2.67) for the 75th percentile. Seventeen of them (73.9%) had metabolic syndrome. However, out of the 6 subjects (26.1%) without metabolic syndrome, 5 subjects had at least one component of metabolic syndrome. There was no correlation between age and insulin resistance. However, there was a correlation between BMI and insulin resistance (p<0.017). There were 53 elderly females (57.6%) with metabolic syndrome; the most common metabolic syndrome component being hypertension (79.3%), followed by HDL hypocholesterolemia (55.4%), and central obesity (53%). As many as 32.1% of subjects with metabolic syndrome also demonstrated insulin resistance. CONCLUSION: The value of insulin resistance was 2.67 (HOMA-IR cut-off > 75 percentile). Subjects with insulin resistance had at least one component of metabolic syndrome. A high prevalence (57.6%) of metabolic syndrome in elderly females living in a nursing home was found.
Estimating the annual cost of overactive bladder in Indonesia.
AIM: to estimate the annual economic cost and quality of life related to OAB in Indonesia population by taking into account the direct cost, value of lost productivity and cost consequences associated with OAB. METHODS: cross sectional study was done in Geriatric Clinic and Urogynaecology Clinic in Dr. Cipto Mangunkusumo Hospital Jakarta from July 2005 to March 2006. Primary outcome of this study was annual cost of OAB, symptom and quality of life of OAB patients. Cost data related to personal routine care of OAB and transportation expenditures were obtained by using questionnaires modified from Dowell Bryant incontinence cost index validated questioner. Data related to quality of life were obtained by OAB-q questioner. Subjects included 30 male and female OAB patients aged 18-100 years. RESULTS: most of patients were female (96.7%). Median of age was 62.5 (30-93) years old, 56.7% patients were elderly (age more than 60 years). Median of total annual cost of OAB was Rp. 2,850,000,-. Median of total personal cost which consist of routine personal care costs and treatment costs were Rp. 2,850,000. Median of total cost which is expended by government for routine personal and treatment of OAB was Rp.2,500,000,- . Median score of symptom severity was 62.5. Quality of life score was divided into coping, concern, sleep, and social item. Median of coping score was 50.0, concern score was 43.1, sleep score was 50.8, and social score was 38.8. Median of total quality of life score was 44.7. Maximum score of symptom severity and quality of life should be 98.8. The higher the score, the more severe the symptom, but the better is the quality of life. CONCLUSION: total annual cost of OAB was Rp. 2,850,000, Quality of life of OAB patient was somewhat poor.